Basic Information
| Provider Information | |||||||||
| NPI: | 1023017894 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | IGNOCHECK | ||||||||
| FirstName: | ANTHONY | ||||||||
| MiddleName: | RAYMOND | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1202 STATE ST | ||||||||
| Address2: | |||||||||
| City: | ERIE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 165011914 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8144544530 | ||||||||
| FaxNumber: | 8144562375 | ||||||||
| Practice Location | |||||||||
| Address1: | 1202 STATE ST | ||||||||
| Address2: | |||||||||
| City: | ERIE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 165011914 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8144544530 | ||||||||
| FaxNumber: | 8144562375 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/14/2005 | ||||||||
| LastUpdateDate: | 06/15/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MD036366E | PA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 212566 | 01 | PA | UPMC | OTHER | 2472864 | 01 | OH | OH MEDICAL ASSISTANCE | OTHER | 183255 | 01 | PA | BLUE SHIELD | OTHER | 080094059 | 01 | PA | RR MEDICARE | OTHER | 518504 | 01 | PA | AETNA | OTHER | 66426 | 01 | PA | UNISON | OTHER | 0011703370002 | 05 | PA | MEDICAID | 01982489 | 01 | PA | NY MEDICAL ASSISTANCE | OTHER | P000398 | 01 | PA | GATEWAY | OTHER | 00051110001 | 01 | NY | UNIVERA | OTHER |